Cancer drugs A to Z list
Enfortumab vedotin and pembrolizumab is a cancer drug combination. Enfortumab vedotin is also known as Padcev. Pembrolizumab is also called Keytruda.
You pronounce enfortumab vedotin as en-fort-u-mab veh-doh-tin. And pembrolizumab as pem-bro-lih-zoo-mab.
It is a treatment for some people with cancer:
that starts in the lining of the , or
that cannot be removed during an operation (unresectable) or has spread further away in the body (metastatic cancer)
who can have treatment with a drug
Doctors call cancer that starts in the lining of the bladder urothelial bladder cancer. Cancer that starts in the lining of the kidney or ureter is called upper urinary tract urothelial cancer.
You may also have enfortumab vedotin and pembrolizumab as part of a .
Find out about your cancer type from our A to Z list
Enfortumab vedotin is a type of cancer drug called an antibody drug conjugate (ADC). This means it is made up of 2 drugs:
enfortumab – a type of called a monoclonal antibody
vedotin (monomethyl auristatin E or MMAE) – a drug
Enfortumab targets cancer cells by attaching to a particular protein on the surface of the cancer cell. This protein is called nectin-4. Enfortumab then releases the vedotin into the cancer cell. It damages or kills the cell. This stops the cancer cells from growing.
Pembrolizumab is a type of . It stimulates the body's to fight cancer by targeting and blocking a protein called PD-1. This is found on the surface of certain immune cells called . Blocking PD-1 triggers the T cells to find and kill cancer cells.
You have enfortumab vedotin and pembrolizumab as a drip into your bloodstream (intravenously).
You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:
central line
PICC line
portacath
You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm. You have a new cannula each time you have treatment.
When you are having this treatment through a cannula it could damage the tissue if it leaks out of the vein. This is called extravasation. This can happen anywhere along the vein that the drug is going into. It doesn’t happen very often. Tell your nurse straight away if you notice any changes such as swelling, redness, pain, burning, or a stinging feeling.
Your nurse will stop the drug treatment. And they will treat the area to relieve symptoms and reduce tissue damage. Contact your healthcare team if you develop any of these symptoms when you are at home.
Read more about having cancer drugs into your vein
You have enfortumab vedotin and pembrolizumab as cycles of treatment. This means you have the drugs and then a rest to allow your body to recover. You might have either:
a cycle of enfortumab vedotin and pembrolizumab over 21 days (3 weeks)
a cycle of enfortumab vedotin and pembrolizumab over 42 days (6 weeks)
You have enfortumab vedotin as a drip into your bloodstream over 30 minutes.
You have pembrolizumab as a drip into your bloodstream over 30 minutes.
You have no treatment.
You have enfortumab vedotin as a drip into your bloodstream over 30 minutes.
You have no treatment.
You then start a new cycle of treatment.
You have enfortumab vedotin as a drip into your bloodstream over 30 minutes.
You have pembrolizumab as a drip into your bloodstream over 30 minutes.
You have no treatment.
You have enfortumab vedotin as a drip into your bloodstream over 30 minutes.
You have no treatment.
You have enfortumab vedotin as a drip into your bloodstream over 30 minutes.
You have no treatment.
You have enfortumab vedotin as a drip into your bloodstream over 30 minutes.
You have no treatment.
You then start a new cycle of treatment.
You continue having enfortumab vedotin for as long as the treatment is working and you are not experiencing too many side effects.
You have pembrolizumab for as long as it works and you are not experiencing too many side effects. You may have it for up to 2 years if you have it every 3 weeks. But you might have treatment for longer if you have it every 6 weeks.
You have blood tests before and during your treatment. They check your levels of and other substances in the blood. They also check how well your liver and kidneys are working.
Before treatment starts you may have a blood test to check for viruses such as hepatitis B, hepatitis C, and HIV. This is called a viral screen.
It’s important for your doctor to know if you have had any of these viruses. This is because this treatment can weaken your and can cause the virus to become active again (reactivation).
Side effects can vary from person to person. They also depend on what other treatment you are having.
Your doctor, pharmacist or nurse will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
you have severe side effects
your side effects aren’t getting any better
your side effects are getting worse
Early treatment can help manage side effects better.
We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.
Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Increased risk of getting an infection is due to a drop in . Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or a burning feeling when peeing, or generally feeling unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
Tell your healthcare team straightaway if you get a high temperature. Ask them if you can take paracetamol to help lower your temperature.
You might be breathless and look pale due to a drop in . This is called anaemia.
A build up of fluid may cause swelling in your arms, hands, ankles, legs, face and other parts of the body. Contact your healthcare team if this happens to you.
This treatment can cause numbness, tingling or prickling sensations most often in the hands and feet. It can happen to other parts of the body as well, but this is less common.
Occasionally you may get muscle weakness, cramps, twitching and pain in your hands and feet. You might find it difficult to do everyday things like write, do up buttons, climb stairs or you may feel clumsy. Other problems include a reduced or loss of sense of touch.
Rarely you may have unusual feelings like your skin is burning or as if something is crawling on the skin. And you may lose movement or sensation in your foot or leg. This treatment can also cause a sharp, shooting or shocking pain that is caused by irritation or damage to a nerve. This can happen to any nerve in the body.
You can also develop a long term condition called myasthenia gravis. This causes muscle weakness to any part of the body but most commonly in the face. But this is rare.
Nerve changes are often temporary and can improve after you finish treatment. For some people they may be permanent.
Tell your healthcare team if you're finding it difficult to walk or complete fiddly tasks such as doing up buttons.
You might notice skin changes including dry or itching skin. You may also get a flat or raised rash.
Occasionally the rash might be made up of blisters. Or look like targets on the skin, with a dark outer edge and middle and a lighter patch in between. You might also get a rash that looks like acne.
The skin on your hands and feet may become sore, red or may peel. And you may have tingling, numbness, pain and dryness in them. This is called hand-foot syndrome or palmar plantar syndrome.
Your skin may also become inflamed, cracked or have rough patches. Or it may look red or darker than normal. And you can get patches of skin that are darker or lighter than your usual skin colour.
Rarely you might get redness or a darker rash that covers large parts of your body and the skin may go scaly and peel. You might also become sore in the folds of your skin. This can include areas such as in your groin or armpits.
Other rare skin changes include a severe skin reaction that may start as tender red patches which leads to peeling or blistering of the skin. You might also feel feverish, and your eyes may be more sensitive to light. This is serious and could be life threatening.
You might feel very tired and as though you lack energy.
Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.
Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.
Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain . But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables.
Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.
You may have some hair loss or hair thinning. This can be upsetting. Your hair might grow back once treatment has finished.
You might not feel like eating and may lose weight. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss.
Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.
Taste changes may make you go off certain foods and drinks. You may also find that some foods taste different from usual or that you prefer to eat spicier foods. Your taste gradually returns to normal a few weeks after your treatment finishes.
You might have liver changes which may go back to normal when treatment finishes.
Rarely you may get inflammation of the liver (hepatitis). Symptoms include yellowing of the skin or eyes, feeling or being sick, bleeding or bruising, dark pee, and stomach pain.
You have regular blood tests to check for any changes in the way your liver is working.
Your eyes may feel dry.
Occasionally you may get an eye infection (conjunctivitis). This can make your eyes feel gritty, itchy, sticky from pus, watery and look red.
Rarely you may get inflammation of the eye. This can cause blurred vision, eye pain, redness in your eye, changes in vision, and flashes of light.
Tell your healthcare team if you get any of these symptoms. They may be able to give you some drops to help.
The level of your hormones may drop (hypothyroidism). You may feel tired or cold, gain weight, feel sad or depressed, or your voice may deepen.
Occasionally you might have higher levels of thyroid hormones. This can cause irregular or fast heart rate (palpitations), weight loss, anxiety and mood swings.
Rarely you might get inflammation of the thyroid gland. Doctors call this thyroiditis.
You have regular blood tests to check your thyroid hormone levels.
High blood sugar levels can cause headaches, feeling thirsty and blurred vision. You have regular tests to check your blood sugar levels. You may need to check your levels more often if you have diabetes.
Rarely this treatment can cause .
Tell your health care team straight away if you have any symptoms of a high blood sugar.
You might develop a cough or breathing problems. This could be due to infection, such as pneumonia or inflammation of the lungs (pneumonitis).
Tell your healthcare team if you keep getting headaches. They can find out the cause and may give you medicine to help.
is easier to sort out if you treat it early. Drink plenty and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your healthcare team if you think you are constipated. They can give you a laxative if needed.
Tell your doctor or nurse if you have this. They can check for the cause of the pain and give you medicine to help.
You might feel some pain from your muscles and joints. Speak to your doctor or nurse about what painkillers you can take to help with this.
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
sepsis - a serious reaction to an infection. Signs can include feeling very unwell, not peeing enough, a very high or very low temperature, shivering, slurred speech or confusion, breathlessness, mottled or discoloured skin or muscle pain. Call 999 or go to accident and emergency (A&E) immediately if you have any of these symptoms
inflammation around the drip site – tell your nurse straight away if you have any pain, redness, swelling or leaking around your drip site
an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness. Some allergic reactions can be life threatening. Alert your nurse if you notice any of these symptoms
a drop in the number of in your blood (thrombocytopenia)
a sore or dry mouth
changes in the way you walk
an increased amount of the lipase in your blood
changes in the levels of minerals and salts in your body - includes low sodium and potassium levels, or low or high levels of calcium
difficulty falling asleep or staying asleep (insomnia)
inflammation of the muscles causing weakness and pain
high blood pressure - symptoms can include blurred vision, nosebleeds, dizziness, headaches, shortness of breath and chest pain
inflammation of the bowel (colitis) which can cause diarrhoea and tummy pain
an irregular heartbeat
chills and flu-like symptoms
dizziness
These side effects happen in fewer than 1 in 100 people (less than 1%). You might have one or more of them. They include:
a condition where cells in your body clump together to make lumps. This usually affects your lungs and skin
damage to the which can cause a drop in the level of certain hormones such as cortisol
inflammation in different organs of your body including the , kidneys, stomach and
seizures (fits)
inflammation of the muscles in the heart
ulcers in your stomach or small bowel
There isn't enough information to work out how often these side effects might happen. You might have one or more of them. They include:
a build up of a substance called ketones in the blood (diabetic ketoacidosis). Symptoms include feeling very thirsty, being sick, peeing more than usual, and fainting. Tell your healthcare team straightaway if you get any of these symptoms
your body rejecting an
Enfortumab vedotin is a new drug in cancer treatment. So there is limited information available at the moment about possible rare and longer term effects that it may cause. Tell your doctor if you notice anything that is not normal for you.
We have more information about side effects and tips on how to cope with them.
Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.
Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.
It is not known whether this treatment affects in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.
This treatment may harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you are having treatment. And women must not become pregnant for at least 6 months after the end of treatment with enfortumab vedotin and pembrolizumab. Men should not get someone pregnant for at least 4 months after finishing enfortumab vedotin.
Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment.
Do not breastfeed during treatment with enfortumab vedotin and pembrolizumab and for at least 6 months after finishing enfortumab vedotin. This is because the drugs may come through into your breast milk.
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having.
Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, and yellow fever.
You can usually have:
other vaccines, but they might not give you as much protection as usual
the flu vaccine (as an injection)
the coronavirus (COVID-19) vaccine
Talk to your doctor or pharmacist about the best time to have a vaccine in relation to your cancer treatment.
You can be in contact with other people who have had live vaccines as injections. If someone has had a live vaccine by mouth or nasal spray there may be a small risk the vaccine virus can be passed onto you if your is weakened.
Your healthcare team will let you know if you need to take any precautions if you are in close contact with someone who has had a live vaccine.
For further information about each drug and the possible side effects go to the electronic Medicines Compendium (eMC) website. You can find patient information leaflets for each drug on this website.
You can report any side effect you have to the Medicines and Healthcare Regulatory Agency (MHRA) as part of their Yellow Card Scheme.
Last reviewed: 20 Apr 2026
Next review due: 20 Apr 2029
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